Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Primary Care
Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

“It’s MAGIC” - development of a manageable geriatric assessment for general practice use

Authors: Tanja Barkhausen, Ulrike Junius-Walker, Eva Hummers-Pradier, Christiane A Mueller, Gudrun Theile

Published in: BMC Primary Care | Issue 1/2015

Login to get access

Abstract

Background

Geriatric assessments are established tools in institutional care since they enable standardized detection of relevant age-related disorders. Geriatric assessments could also be helpful in general practice. However, they are infrequently used in this setting, mainly due to their lengthy administration. The aim of the study was the development of a “manageable geriatric assessment – MAGIC”, specially tailored to the requirements of daily primary care.

Methods

MAGIC was developed based on the comprehensive Standardized Assessment for Elderly People in Primary Care (STEP), using four different methodological approaches: We relied on A) the results of the PRISCUS study by assessing the prevalence of health problems uncovered by STEP, the importance of the respective problems rated by patients and general practitioners, as well as the treatment procedures initiated subsequently to the assessment. Moreover, we included findings of B) a literature analysis C) a review of the STEP assessment by experienced general practitioners and D) focus groups with general practitioners.

Results

The newly created MAGIC assessment consists of 9 items and covers typical geriatric health problems and syndromes: function, falls, incontinence, cognitive impairment, impaired ears and eyes, vaccine coverage, emotional instability and isolation.

Conclusions

MAGIC promises to be a helpful screening instrument in primary care consultations involving elderly multimorbid patients. Applicable within a minimum of time it still covers health problems highly relevant with regard to a potential loss of autonomy. Feasibility will be tested in the context of a large, still ongoing randomized controlled trial on “reduction of potentially inadequate medication in elderly patients” (RIME study; DRKS-ID: DRKS00003610) in general practice.
Literature
1.
Sandholzer H, Hellenbrand W, Renteln-Kruse W, Van Weel C, Walker P. STEP–standardized assessment of elderly people in primary care. Dtsch Med Wochenschr. 2004;129 Suppl 4:S183–226.CrossRefPubMed
2.
Junius U, Fischer G. Geriatric assessment for use in primary case - results of a concerted action involving seven European countries. Z Gerontol Geriatr. 2002;35(3):210–23.CrossRefPubMed
3.
Eichler K, Scrabal C, Steurer J, Mann E. Preventive health risk appraisal for older people and impact on GPs’ patient management: a prospective study. Fam Pract. 2007;24(6):604–9.CrossRefPubMed
4.
Piccoliori G, Gerolimon E, Abholz H. Geriatric assessment in general practice using a screening instrument: is it worth the effort? Results of a South Tyrol study. Age Ageing. 2008;37(6):647–52.CrossRefPubMed
5.
Voigt I, Wrede J, Diederichs-Egidi H, Dierks M, Junius-Walker U. Priority setting in general practice: health priorities of older patients differ from treatment priorities of their physicians. Croat Med J. 2010;51(6):483–92.CrossRefPubMedPubMedCentral
6.
Thiem U, Hinrichs T, Müller CA, Holt-Noreiks S, Nagl A, Bucchi C, et al. [Prerequisites for a new health care model for elderly people with multiple morbidities: results and conclusions from 3 years of research in the PRISCUS consortium]. Z Gerontol Geriatr. 2011;44 Suppl 2:101–12.CrossRefPubMed
7.
Min L, Kerr EA, Blaum CS, Reuben D, Cigolle C, Wenger N. Contrasting effects of geriatric versus general medical multimorbidity on quality of ambulatory care. J Am Geriatr Soc. 2014;62(9):1714–21.CrossRefPubMedPubMedCentral
8.
Fletcher AE, Jones DA, Bulpitt CJ, Tulloch AJ. The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848]. BMC Health Serv Res. 2002;2(1):21.CrossRefPubMedPubMedCentral
9.
Richardson J. The easy-care assessment system and its appropriateness for older people. Nurs Older People. 2001;13(7):17–9.CrossRefPubMed
10.
van Kempen JA, Schers HJ, Melis RJ, Olde Rikkert MG. Construct validity and reliability of a two-step tool for the identification of frail older people in primary care. J Clin Epidemiol. 2014;67(2):176–83.CrossRefPubMed
11.
Illiffe S, Lenihan P, Orrell M, Walters K, Drennan V, Thai SS, et al. The development of a short instrument to identify common unmet needs in older people in general practice. Br J Gen Pract. 2004;54(509):914–8.
12.
Van Weel C. Functional status in primary care: COOP/WONCA charts. Disabil Rehabil. 1993;15(2):96–101.CrossRefPubMed
13.
Lachs MS, Feinstein AR, Cooney Jr LM, Drickamer MA, Marottoli RA, Pannill FC, et al. A simple procedure for general screening for functional disability in elderly patients. Ann Intern Med. 1990;112(9):699–706.CrossRefPubMed
14.
Gallo JJ, Reichel W, Anderson LM. Handbook of Geriatric Assessment. Gaithersburg, Maryland: Aspen-Publishers; 1995.
15.
16.
Sandvik H, Hunskaar S, Vanvik A, Bratt H, Seim A, Hermstad R. Diagnostic classification of female urinary incontinence: an epidemiological survey corrected for validity. J Clin Epidemiol. 1995;48(3):339–43.CrossRefPubMed
17.
18.
Nelson E, Wasson J, Kirk J, Keller A, Clark D, Dietrich A, et al. Assessment of function in routine clinical practice: description of the COOP Chart method and preliminary findings. J Chronic Dis. 1987;40 Suppl 1:55S–69S.CrossRefPubMed
19.
Whooley MA, Avins AL, Miranda J, Browner WSJ. Case-finding instruments for depression. Two questions are as good as many. Gen Intern Med. 1997;12(7):439–45.CrossRef
20.
Watson YI, Arfken CL, Birge SJ. Clock completion: an objective screening test for dementia. J Am Geriatr Soc. 1993;41(11):1235–40.CrossRefPubMed
21.
Shulman KI. Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry. 2000;15(6):548–61.CrossRefPubMed
22.
Lawshe CH. A quantitative approach to content validity. Person Psychol. 1975;28:563–75.CrossRef
23.
Walters K, Iliffe S, Tai SS, Orrell M. Assessing needs from patient, carer and professional perspectives: The Camberwell assessment of need for elderly people in primary care. Age Ageing. 2000;29(6):505–10.CrossRefPubMed
24.
25.
Hunt SM, McKenna SP, McEwen J, Williams J, Papp E. The Nottingham health profile: Subjective health status and medical consultations. Soc Sci Med A. 1981;15(3 PART 1):221–9.PubMed
26.
Parkerson Jr GR, Broadhead WE, Tse C-J. Development of the 17-item Duke health profile. Fam Pract. 1991;8(4):396–401.CrossRefPubMed
27.
Gilson BS, Gilson JS, Bergner M, Bobbit RA, Kressel S, Pollard WE, et al. The sickness impact profile. Development of an outcome measure of health care. Am J Public Health. 1975;65(12):1304–10.CrossRefPubMedPubMedCentral
28.
Davison J, Bond J, Dawson P, Steen IN, Kenny RA. Patients with recurrent falls attending accident & emergency benefit from multifactorial intervention - a randomised controlled trial. Age Ageing. 2005;34(2):162–8.CrossRefPubMed
29.
Caplan GA, Williams AJ, Daly B, Abraham K. A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department - The DEED II study. J Am Geriatr Soc. 2004;52(9):1417–23.CrossRefPubMed
30.
McCusker J, Dendukuri N, Tousignant P, Verdon J, De Courval LP, Belzile E. Rapid two-stage emergency department intervention for seniors: Impact on continuity of care. Acad Emerg Med. 2003;10(3):233–43.CrossRefPubMed
31.
Bath P, Philp I, Boydell L, McCormick W, Bray J, Roberts H. Standardized health check data from community-dwelling elderly people: the potential for comparing populations and estimating need. Health Soc Care Community. 2000;8(1):17–21.CrossRefPubMed
32.
Hofmann W, Nikolaus T, Pientka L, Stuck AE. Working group ‘geriatric assessment’ (AGAST): guidelines for assessment instruments. Z Gerontol. 1995;28(1):29–34.
33.
34.
Zimmer B, Icks A. Hausärztlich-geriatrisches basisassessment - Erfassung der Alltagskompetenz und des Hilfebedarfs bei älteren Patienten durch den Hausarzt als Leistung des neuen EBM. Rheinisches Ärzteblatt. 2005;59(9):13–13.
35.
Fleming KC, Evans JM, Weber DC, Chutka DS. Practical functional assessment of elderly persons: a primary-care approach. Mayo Clin Proc. 1995;70(9):890–910.CrossRefPubMed
36.
37.
38.
39.
Tattersall C, Powell J, Stroud J, Pringle J. Mind mapping in qualitative research. Nurs Times. 2011;107(18):20–2.PubMed
40.
Holt S, Schmiedl S, Thurmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int. 2010;107(31–32):543–51.PubMedPubMedCentral
41.
Stuck AE, Walthert JM, Nikolaus T, Bula CJ, Hohmann C, Beck JC. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999;48(4):445–69.CrossRefPubMed
42.
Helvik AS, Selbaek G, Engedal K. Functional decline in older adults one year after hospitalization. Arch Gerontol Geriatr. 2013;57(3):305–10.CrossRefPubMed
43.
Chu-Ai Teh R, Lim WS, Basri R, Ismail NH. Utility of a patient-response screening question for visual impairment. J Am Geriatr Soc. 2006;54(2):370–2.CrossRefPubMed
44.
Lin FR, Thorpe R, Gordon-Salant S, Ferrucci L. Hearing loss prevalence and risk factors among older adults in the United States. J Gerontol A Biol Sci Med Sci. 2011;66(5):582–90.CrossRefPubMed
45.
Knudtson MD, Klein BE, Klein R. Age-related eye disease, visual impairment, and survival: the Beaver Dam eye study. Arch Ophthalmol. 2006;124(2):243–9.CrossRefPubMed
46.
Heasley K, Buckley JG, Scally A, Twigg P, Elliott DB. Falls in older people: effects of age and blurring vision on the dynamics of stepping. Invest Ophthalmol Vis Sci. 2005;46(10):3584–8.CrossRefPubMed
47.
Beckman AG, Parker MG, Thorslund M. Can elderly people take their medicine? Patient Educ Couns. 2005;59(2):186–91.CrossRefPubMed
48.
49.
Squirrell DM, Kenny J, Mawer N, Gupta M, West J, Currie ZI, et al. Screening for visual impairment in elderly patients with hip fracture: validating a simple bedside test. Eye (Lond). 2005;19(1):55–9.CrossRef
50.
Chia EM, Mitchell P, Rochtchina E, Foran S, Golding M, Wang JJ. Association between vision and hearing impairments and their combined effects on quality of life. Arch Ophthalmol. 2006;124(10):1465–70.CrossRefPubMed
51.
Pacala JT, Yueh B. Hearing deficits in the older patient: “I didn’t notice anything”. JAMA. 2012;307(11):1185–94.CrossRefPubMed
52.
Kalinowski MA. “Eye” dentifying vision impairment in the geriatric patient. Geriatr Nurs. 2008;29(2):125–32.CrossRefPubMed
53.
Stenhagen M, Ekstrom H, Nordell E, Elmstahl S. Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study ‘Good ageing in Skane’. BMC Geriatr. 2013;13:81–2318. 13-81.CrossRefPubMedPubMedCentral
54.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9, CD007146.
55.
Kannus P, Sievanen H, Palvanen M, Jarvinen T, Parkkari J. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366(9500):1885–93.CrossRefPubMed
56.
Antes DL, D‘Orsi E, Benedetti TR. Circumstances and consequences of falls among the older adults in Florianopolis. Epi Floripa Aging 2009. Rev Bras Epidemiol. 2013;16(2):469–81.CrossRefPubMed
57.
Klausner AP, Vapnek JM. Urinary incontinence in the geriatric population. Mt Sinai J Med. 2003;70(1):54–61.PubMed
58.
Omli R, Hunskaar S, Mykletun A, Romild U, Kuhry E. Urinary incontinence and risk of functional decline in older women: data from the Norwegian HUNT-study. BMC Geriatr. 2013;13(1):47.CrossRefPubMedPubMedCentral
59.
Berardelli M, De Rango F, Morelli M, Corsonello A, Mazzei B, Mari V, et al. Urinary incontinence in the elderly and in the oldest old: correlation with frailty and mortality. Rejuvenation Res. 2013;16(3):206–11.CrossRefPubMed
60.
Ko Y, Lin SJ, Salmon JW, Bron MS. The impact of urinary incontinence on quality of life of the elderly. Am J Manag Care. 2005;11(4 Suppl):S103–11.PubMed
61.
Chutka DS, Fleming KC, Evans MP, Evans JM, Andrews KL. Urinary incontinence in the elderly population. Mayo Clin Proc. 1996;71(1):93–101.CrossRefPubMed
62.
Buchtemann D, Luppa M, Bramesfeld A, Riedel-Heller S. Incidence of late-life depression: a systematic review. J Affect Disord. 2012;142(1–3):172–9.CrossRefPubMed
63.
Chapman DP, Perry GS. Depression as a major component of public health for older adults. Prev Chronic Dis. 2008;5(1):A22.PubMed
64.
Haustein T, Mischke J. Ältere Menschen in Deutschland und der EU. 1st ed. Wiesbaden: Statistisches Bundesam; 2011.
65.
Eisele M, Zimmermann T, Kohler M, Wiese B, Heser K, Tebarth F, et al. Influence of social support on cognitive change and mortality in old age: results from the prospective multicentre cohort study AgeCoDe. BMC Geriatr. 2012;12:9. 2318-12-9.CrossRefPubMedPubMedCentral
66.
67.
Weyerer S. Altersdemenz. In: Robert-Koch-Institut, editor. Gesundheitsberichterstattung des Bundes, vol. Volume 28. Berlin: Robert-Koch Institut; 2005. p. 1–38.
68.
Staehelin HB. Epidemiologie der Demenzerkrankungen. Schweiz Med Forum. 2004;4:247–50.
69.
Overcash JA, Beckstead J, Extermann M, Cobb S. The abbreviated comprehensive geriatric assessment (aCGA): a retrospective analysis. Crit Rev Oncol Hematol. 2005;54(2):129–36.CrossRefPubMed
Metadata
Title
“It’s MAGIC” - development of a manageable geriatric assessment for general practice use
Authors
Tanja Barkhausen
Ulrike Junius-Walker
Eva Hummers-Pradier
Christiane A Mueller
Gudrun Theile
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-014-0215-4

Other articles of this Issue 1/2015

BMC Primary Care 1/2015 Go to the issue

Research article

The ‘vicious cycle’ of personalised asthma action plan implementation in primary care: a qualitative study of patients and health professionals’ views

Research article

Contacts with out-of-hours primary care for nonurgent problems: patients’ beliefs or deficiencies in healthcare?

Research article

Training general practitioners in early identification and anticipatory palliative care planning: a randomized controlled trial

Research article

General practitioners’ perceptions on home medicines reviews: a qualitative analysis

Research article

Self-care behavior when suffering from the common cold and health-related quality of life in individuals attending an annual checkup in Japan: a cross-sectional study

Research article

Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis